2003, 09-15 Permit Application: BLD-03-02475 Gas Furnaces & Piping(3T1' (N'
Sokane
�,,.•�Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509 - 688 -0036 - Phone
Spokane Valley, WA `99206
509 - 688 - 0037 - Fax
PROJECT
ADDRESS: 1■,) : 1 ( ` 3 (I (N S `
PERMIT
USE:
OWNER: C W No.. a L \,Z RI to
PHONE (Daytime Contact): c a g -_
i C,
MAILING ADDRESS:
`
(street) (city /state) (ZIP)
FUEL BURNING APPLIANCE
CONTRACTOR: L k< l
LICENSE #: L '‘A `A A
\QR 0 `k
MAILING ADDRESS:
l -` c L-C/ ik) c, L (3K C;.' o �. '
N ctv (v\k L-.:-._ c: At. Cc), W,,
PHONE #: _
C, C? i..-. *7 (O f?J" J (n b k
Qlcj,b -e--(‘D
FUEL BURNING APPLIANCE
(street) (city /state) (ZIP)
"''
METHOD OF PA
❑ CASH ❑ C
DATE:
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
9 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
= OR <100,000
X
$15
=
2
FUEL BURNING APPLIANCE
> 100,000
"''
X
$19
=
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
= OR <400,000
X
$50
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
$100
=
5
USED APPLIANCE (WSEC min. AFUE rating)
= or <400,000
X
$50
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100
=
7
BOILER /REFRIGERATION
1 - 100M BTU
X
$15
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39
=
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
$57
=
11
BOILER/REFRIGERATION
+1750M BTU
X
$95
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$10
=
13
RANGE
--
X
910
=
14
DRYER
-
X
$10
15
FUEL BURNING WATER HEATER
--
X
$10
=
16
MISC FUEL BURNING APPL.
-
X
$10
17
GAS PIPING (ea. Outlet)
-
X
$1
18
DUCT SYSTEMS
-
L
X
$10
19
VENTILATING FANS
-
X
$10
=
20
AIR HANDLER (DOES NOT include ducting)
= OR < 10,000CFM
X
$12
=
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19
22
EVAPORATIVE COOLERS
-
X
$10
=
23
TYPE I HOOD
-
X
$50
-
24
TYPE II HOOD
-
X
$10
25
HEAT PUMP /AIR CONDITIONER
0-3 TON
X
$12
26
AIR CONDITIONER
3-15 TON
X
$20
=
27
AIR CONDITIONER
15-30 TON
X
$25
28
AIR CONDITIONER
30 -50 TON
X
$35
=
29
AIR CONDITIONER
+50 TON
X
$60
30
LPG STORAGE TANK
-
X
$10
-
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
=
32
WOOD STOVE - FREE STANDING
-
X
$25
KENT
VISA' I _.. Z -
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
METHOD OF
❑ CASH
DATE:
*Wane
Spokane
,,,.Va11ey
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509 - 688 -0036 Phone
Spokane Valley, W3' 9920.5
509 - 688 -0037 - Fax
PROJECT
ADDRESS:
DESCRIPTION
PERMIT
USE:
OWNER:
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
(street)
(city /state) (ZIP)
CONTRACTOR:
LICENSE #:
MAILING ADDRESS:
-
PHONE #:
2
(street)
(city /state) (ZIP) .
PLUMBING FIXTURES
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION
_ DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6
-
2
URINALS
X
$6
-
3
TUBS
X
$6
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
X
$6
=
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP /CULINARY/MEAT
X
$6
-
6
DISHWASHER
X
$6
-
7
CLOTHES WASHER
X
$6
-
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/DRAIN -IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6
-
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND /OR COFFEE MAKER, HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X'
■
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
$6
=
PAYMENT
CHECK
VISA
Ma. s ..F
:_._ . -__" .
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
• ■
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: